All you need to know about varicose eczema.

Varicose eczema occurs when the veins in the lower limbs lose their tone and no longer transport blood to the heart as efficiently. Indeed, when everything is functioning correctly, the blood circulating in the veins rises from the legs to reach the heart. To counteract gravity, the veins use valves, acting like flaps to prevent the backflow of blood. However, if these are damaged, the valves can no longer fulfil their role, leading to the stagnation of blood in the legs. This phenomenon is called venous stasis. It is also referred to as varicose veins or dilation of the veins under pressure. This condition is characterised by swelling and stasis. The excessive pressure of the blood on the walls of the veins causes a distension of the skin and its inflammation : this is the onset of varicose eczema.

It remains unknown why some individuals suffering from venous insufficiency only experience sensations of heaviness in the legs, while others develop stasis dermatitis in the absence of treatment. Doctors hypothesise that these patients have a predisposition on a genetic level. Furthermore, factors such as overweight, sedentary lifestyle, and occupations that require prolonged standing, such as hairdressers or pharmacists, exacerbate the condition.

Varicose eczema is a dermatological disorder that progresses in several stages. The first is characterised by feelings of heavy legs. Due to the pressure exerted by the blood on the walls of the veins, these expand and the skin then reveals some small vessels. At this stage, it is possible to detect a varicose vein when an ultrasound is performed. The oedema and swelling of the legs continue to intensify until they cause inflammation of the skin: itching sensations then appear, marking the onset of varicose eczema.

Under the effect of scratching, crusts form on the skin, causing weeping lesions. The area then becomes infected. Complete healing is still possible if varicose eczema is immediately treated. However, in the absence of care, a varicose ulcer develops. This will not heal and the wound will then become chronic.

The prevention of varicose eczema primarily involves the prevention of venous insufficiency. To achieve this, it is recommended to maintain regular physical activity, wear compression stockings during long flights or if you feel the need, and possibly elevate your legs at night to facilitate the return of blood to the heart. The most recommended sports to promote blood circulation are swimming, walking, and cycling.

In addition, if you are prone to heavy legs, you can also prevent varicose eczema by applying a emollient care to your legs daily. This will help to strengthen the skin barrier. With increased protection, the skin will be less prone to inflammation. We also recommend accompanying this action with a massage to stimulate blood circulation.

Several measures can be taken to alleviate the symptoms of varicose eczema. In addition to wearing compression stockings and elevating your legs at night to stimulate blood circulation, the application of cold compresses or certain essential oils, such as tea tree or true lavender, is recommended to reduce itching. The topical corticosteroids prescribed by dermatologists also help to relieve itching episodes and reduce redness, due to the anti-inflammatory properties of the cortisone they contain.

If the itching does not subside or you notice that the lesions are intensifying, it is very important to consult a doctor who may suggest a procedure to remove the varicose veins. Stripping, phlebectomy, sclerotherapy, endovenous laser ablation, radiofrequency... Depending on your age, the severity of your varicose eczema and your tolerance, different surgical options will be considered. The doctor will then discuss the benefits, risks and expected outcomes of each option, while taking into account your needs and preferences.

Note : The sooner you consult a doctor, the less severe the operation and its repercussions will be. That's why we recommend you not to delay in making an appointment, especially if your symptoms of heavy legs persist.

• GOLDENBERG G. & al. Eczema. The Mount Sinai journal of medicine (2011).

• SAURAT J. H., LACHAPELLE J. M., LIPSKER D., THOMAS L. et BORRADORI L. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).